多层螺旋CT平扫及三期动态增强扫描对肝细胞癌的诊断价值研究
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摘要
目的探讨分析多层螺旋CT(MSCT)平扫及三期动态增强扫描对肝细胞癌诊断中的应用价值。方法回顾性分析2015年3月到2017年3月期间收集的52例经手术病理证实患有肝细胞癌患者的CT检查资料,分析CT平扫及三期增强扫描对肝细胞癌的诊断应用价值。结果 (1)运用64排128层螺旋CT多期增强扫描共诊断出14例患者伴有肝硬化,共检出肝癌病灶82个,病灶在CT平扫上显示为稍低密度,在三期动态增强扫描中病灶为"快进快出"式典型强化,具体表现为动脉期强化,其中3个病灶动脉期未明显强化;门脉期强化程度逐渐下降,延迟期呈低密度。与手术病理诊断结果相比,64排128层螺旋CT多期增强扫描三期综合检出率高达100%。(2)多层螺旋CT三期动态增强扫描对肝细胞癌的病灶检出率分别为:动脉期检出率达为96.34%,门脉期的检出率为82.92%,延迟期的检出率为87.80%。结论在临床肝细胞癌诊断中,运用64排128层螺旋CT多期增强扫描,可以清晰反映肝细胞癌的血供变化特点,为临床早期诊断肝细胞癌提供可靠的影像学依据,在肝细胞癌诊断以及病情监测方面有重要的临床意义。
Objective To investigate the value of multi-slice spiral CT(MSCT) plain scanning and three-phase dynamic contrast-enhanced scanning in the diagnosis of hepatocellular carcinoma. Methods CT findings of 52 patients with hepatocellular carcinoma confirmed by surgery and pathology collected from March 2015 to March 2017 were analyzed retrospectively. The CT and CT scanning were analyzed retrospectively. Results(1)There was a total of 82 liver cancer lesions detected in 14 patients with cirrhosis by using 128-slice spiral CT multi-phase contrast-enhanced scan. The lesion displayed a slightly lower density on plain scan, scan lesions in the "fast forward fast" typical enhancement, manifested as arterial phase enhancement, 3 lesions were not significantly enhanced arterial phase; portal phase gradually decreased, the delay period showed low density. Compared with the results of surgical pathology, the comprehensive detection rate of three stages of 64-slice 128-slice spiral CT multi-phase enhanced scan was as high as 100%.(2)The detection rate of three-phase dynamic enhanced CT scan of hepatocellular carcinoma by multi-slice spiral CT were as follows: the detection rate of arterial phase was 96.34%, the detection rate of portal phase was 82.92%, the detection rate of delayed phase was 87.80%. Conclusion In the clinical diagnosis of hepatocellular carcinoma, 64 rows of 128-slice spiral CT multi-phase enhanced scan can clearly reflect the characteristics of blood supply of hepatocellular carcinoma and provide a reliable imaging basis for the early diagnosis of hepatocellular carcinoma. Hepatocellular carcinoma diagnosis and disease monitoring has important clinical significance.
Objective To investigate the value of multi-slice spiral CT(MSCT) plain scanning and three-phase dynamic contrast-enhanced scanning in the diagnosis of hepatocellular carcinoma. Methods CT findings of 52 patients with hepatocellular carcinoma confirmed by surgery and pathology collected from March 2015 to March 2017 were analyzed retrospectively. The CT and CT scanning were analyzed retrospectively. Results(1)There was a total of 82 liver cancer lesions detected in 14 patients with cirrhosis by using 128-slice spiral CT multi-phase contrast-enhanced scan. The lesion displayed a slightly lower density on plain scan, scan lesions in the "fast forward fast" typical enhancement, manifested as arterial phase enhancement, 3 lesions were not significantly enhanced arterial phase; portal phase gradually decreased, the delay period showed low density. Compared with the results of surgical pathology, the comprehensive detection rate of three stages of 64-slice 128-slice spiral CT multi-phase enhanced scan was as high as 100%.(2)The detection rate of three-phase dynamic enhanced CT scan of hepatocellular carcinoma by multi-slice spiral CT were as follows: the detection rate of arterial phase was 96.34%, the detection rate of portal phase was 82.92%, the detection rate of delayed phase was 87.80%. Conclusion In the clinical diagnosis of hepatocellular carcinoma, 64 rows of 128-slice spiral CT multi-phase enhanced scan can clearly reflect the characteristics of blood supply of hepatocellular carcinoma and provide a reliable imaging basis for the early diagnosis of hepatocellular carcinoma. Hepatocellular carcinoma diagnosis and disease monitoring has important clinical significance.
引文
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[13]许有生,顾松根,杨其根.螺旋C T增强延迟扫描在肝病诊断中的作用厂[J].实用放射学杂志,2003,19(11):1044-1046.
[14]陈里,曹旭,杨丁.肝细胞肝癌计算机断层扫描三期动态增强动脉期强化特点与病理分化程度的关系[J].中国肿瘤临床与康复,2015,21(8):916-918.
[15]廖雪燕,谢鉴津,邱菊生,等.小肝细胞癌的少见CT强化表现及分析[J].中国CT和MRI杂志,2015,13(4):56-58.
[2]买二辉,户平安,雷霆,等.螺旋CT三期动态扫描与平扫在肝癌诊断中的应用价值研究[J].中国CT和MRI杂志,2017,15(12):69-71.
[3]朱健,曹治平,唐芳芳.MSCT三期增强扫描对小肝癌的临床诊断价值[J].海南医学,2017,28(2):257-259.
[4]Mahnken A H,Wildberger J E,Sinha A M,et al.Value of 3D-volume rendering in the assessment of coronary arteries with retrospectively ECG-gated multislice spiral CT[J].Acta Radiologica,2015,44(3):302-309.
[5]王婷.螺旋CT对肝脏局灶性结节增生诊断的应用探析[J].中国CT和MRI杂志,2016,14(4):77-79.
[6]刘学聪,刘宝玲,宋丹丹.64层螺旋CT多期动态增强扫描肝细胞肝癌诊断的临床分析[J].医学影像学杂志,2015,25(8):1481-1484.
[7]王建锋.多层螺旋CT双期增强扫描对肝微小细胞癌的诊断价值[J].医学影像学杂志,2016,26(1):74-76.
[8]李明通.肝脏局灶性结节性增生和甲胎蛋白阴性肝细胞癌患者的影像学特点分析[J].临床肝胆病杂志,2015,30(5):729-732.
[9]朱炳印,郭顺林,姚永杰,等.双源CT全肝灌注成像对原发性肝细胞肝癌TACE术后疗效的评估[J].中国CT和MRI杂志,2017,15(8):80-84.
[10]黄峥峥,郑穗生,王龙胜,等.原发性透明细胞型肝癌的三期增强CT表现与病理分化程度研究[J].安徽医学,2015,36(12):1478-1481.
[11]Li Y K,Zheng Y,Chen J W,et al.Determining the organ of origin of large pelvic masses in females using multidetector CT angiography and three-dimensional volume rendering CT angiography[J].European Radiology,2015,25(4):1032-1039.
[12]冯智超,朱文卫,刘倩云,等.动脉增强分数定量彩图对肝脏局灶性结节增生与肝细胞癌的鉴别诊断价值[J].临床放射学杂志,2017,36(2):231-235.
[13]许有生,顾松根,杨其根.螺旋C T增强延迟扫描在肝病诊断中的作用厂[J].实用放射学杂志,2003,19(11):1044-1046.
[14]陈里,曹旭,杨丁.肝细胞肝癌计算机断层扫描三期动态增强动脉期强化特点与病理分化程度的关系[J].中国肿瘤临床与康复,2015,21(8):916-918.
[15]廖雪燕,谢鉴津,邱菊生,等.小肝细胞癌的少见CT强化表现及分析[J].中国CT和MRI杂志,2015,13(4):56-58.